A “necessary evil”? Keeping women out of medical schools won’t fix what ails the Japanese medical profession

by Chelsea Szendi Schieder

GRAPH/Source: Ministry of Health, Labour and Welfare

Abstract

News sources revealed in August 2018 that Tokyo Medical University
has been systematically tampering with its entrance exam scores to
reduce the number of female students at the institution. This scandal
led to a government investigation into medical faculties, and initial
reports suggest that such gender discrimination is widespread in medical
faculty admissions. This issue relates to several stubborn problems
facing Japanese society today: It reflects how a more general context of
gender discrimination threatens to impede new solutions to the crises
facing medicine in Japan as a workplace and as a place of care, and how
recent efforts to counter discriminatory practices and encourage
“diversity” lack accountability. This article shows how the gender gap
in the medical field points to deeper problems in the profession, how
recent research suggests that gender diversity may improve medical
outcomes in terms of patient care, and how this entrance-exam scandal
highlights the inadequacy and lack of accountability behind recent
efforts to promote “diversity.”

On August 2, 2018 an article in the Yomiuri shimbun broke
the news that Tokyo Medical University has been systematically tampering
with the scores of entrance exams to benefit male applicants. The news
emerged in the course of an investigation into the university
administration’s bribe of a high-ranking official at the Ministry of
Education, Sano Futoshi.1*
Officials at the university apparently boosted the entrance exam score
of Sano’s son in exchange for his help in securing a grant to improve
the university’s public image. Along with this case of cronyism, it came
to light that the university routinely padded the scores of all male
applicants except those who had been applying for four or more years.
Apparently believing that women would not do as well in the medical
profession, Tokyo Medical University systematically reduced their
chances of admission for at least a decade. It seems that rising rates
of successful female applicants prompted university officials to impose a
system of automatically increasing male applicants’ scores to reduce
the ratio of female students at their institution. The revelations
prompted a government investigation of 81 schools, which revealed in
December 2018 that at least nine other medical faculties engaged in
similar practices.2

And yet, in 2013, the university began receiving a national grant to
“support women.” Over three years, Tokyo Medical University was awarded
over 80 million yen (about 720,000 USD) through this grant. Two
university executives at the center of the admissions scandal – former
chairman Usui Masahiko and former university president Suzuki Mamoru –
played key roles in the Office to Promote Diversity, founded at the
university in 2016. In Usui’s opening remarks at an event to celebrate
the first anniversary of the Office in 2017, he called on the university
staff to promote “diversity.”3 At
the time, the school presented an increase in female admissions from
26.9% to 32.4% as evidence of its efforts, even as it was actively
taking steps to deny admission to women with qualifying scores.4 That
meant that the university was not only taking money from the government
to promote female admissions but also taking money from individual
female applicants whom it artificially failed (sitting a university
entrance exam in Japan costs 40,000 to 60,000 yen, about 360 to 540
USD). A group of 24 women denied admission to Tokyo Medical University
since 2006 have joined with a team of defense lawyers to build a legal
case against the school, which includes a demand for compensation for
these fees, and potentially for additional damages.5

The male officials and others that implemented systematic
discrimination at Tokyo Medical University have framed their actions as a
“necessary evil.” The key reason cited as a defense for Tokyo Medical
University’s decision to depress female admissions was their concern
that too many female doctors would result in too few doctors at their
affiliated hospitals when women left their work for marriage or
childbirth. In his testimony to the legal team currently investigating
Tokyo Medical University’s discriminatory admissions process, Usui said
that the university systematically depressed female applicants’ scores
because “as women get older, their activities as doctors decrease.”6 This
rhetoric echoed the sensationalistic “Coeds Ruin the Nation Theory”
enunciated in the pages of the Japanese tabloids in the early 1960s.
Then, Waseda University professor of literature Teruoka Yasutaka
declared his desire to set quotas to limit the number of women admitted
to humanities departments because women would waste their educations and
ruin society.7 Now,
male administrators at a number of medical universities secretly impose
quotas fearing that too many women in the profession will ruin
medicine.8

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